Though success will largely depend on the
extent of a patient's injury, flap surgery
and microsurgery have vastly improved a
plastic surgeon's ability to help a severely
injured or disfigured patient. Using advanced
techniques that often take many hours and
may require the use of an operating microscope,
plastic surgeons can now replant amputated
fingers or transplant large sections of
tissue, muscle or bone from one area of
the body to another with the original blood
supply in tact.
A flap is a section of living tissue that
carries its own blood supply and is moved
from one area of the body to another. Flap
surgery can restore form and function to
areas of the body that have lost skin, fat,
muscle movement, and/or skeletal support.
A local flap uses a piece of skin and underlying
tissue that lie adjacent to the wound. The
flap remains attached at one end so that
it continues to be nourished by its original
blood supply, and is repositioned over the
wounded area.
A regional flap uses a section of tissue
that is attached by a specific blood vessel.
When the flap is lifted, it needs only a
very narrow attachment to the original site
to receive its nourishing blood supply from
the tethered artery and vein.
A musculocutaneous flap, also called a muscle
and skin flap, is used when the area to
be covered needs more bulk and a more robust
blood supply. Musculocutaneous flaps are
often used in breast reconstruction to rebuild
a breast after mastectomy. This type of
flap remains "tethered" to its
original blood supply.
In a bone/soft tissue flap, bone, along
with the overlying skin, is transferred
to the wounded area, carrying its own blood
supply.
A microvascular free flap is a section of
tissue and skin that is completely detached
from its original site and reattached to
its new site by hooking up all the tiny
blood vessels.
